What about the cord?

first published 19/12/2015

One of the biggest questions surrounding birth is 'What about the cord?'

Many people have a sense of urgency that the cord must be clamped and cut in a dramatic and special way.  This is not the case.  Far from it in fact.

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You do not have to cut the cord.  AT ALL.

And yes, this means that the baby remains attached to the placenta.  It is useful to have a bowl ready for it.  Once the cord is white (after a few hours) it can be cut without need for tying (about 10cm away from the baby.).  The cord will continue to dry out and come away from the baby after a few days.  The placenta can be encapsulated, printed, eaten, planted or frozen.

Some people choose to leave the cord intact. This does involve more considerations (as described by lotus birth).  After a few days the cord and placenta come away from the baby. 
 

With this in mind, you can relax. Leave your shoelaces in your shoes, and put the scissors away while you #waitforwhite.   

If you find yourself birthing without assistance (as you may in the event of a fast birth), simply leave the cord alone.  Don't pull on it, don't clamp it, don't cut it.  

BUT WHAT IF THE CORD IS AROUND THE BABY'S NECK!

There is a lot of misunderstanding about nuchal cords (cord around the neck).  The cord around neck is rarely a problem, and the 'somersault manoeuver' (see below) is useful to know about. Understanding nuchal cords and this manoeuver can be very reassuring in the event of an unassisted birth.  It is also helpful to understand even when being assisted, as you will be more aware of the language and less likely to feel anxious or confused about this situation.  Knowledge is Power!

Midwife Thinking has written an excellent article discussing nuchal cords. This includes a description of the somersault manoeuver (also shown in the video below).


WHAT IF THERE IS A KNOT IN THE CORD?

You may have heard that in very rare situations a baby has a 'true knot' in the umbilical cord.  For this, I encourage you to read this article by midwife, Jane Palmer.



AND WHAT IS THE DEAL WITH DELAYED CORD CLAMPING?

At some point you are likely to heard about delayed cord clamping, the evidence supports it, and it is increasingly becoming standard practice (to varying degrees).  You still need to request it, however, and discuss it with your care provider to find out just what they consider standard.  If this differs to what you want, you will need to discuss this with them to ensure your needs are met.  An excellent resource and campaign is #waitforwhite

WHAT ABOUT CORD BLOOD BANKING?
You can read about that here.

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The video below demonstrates the somersault manoeuver. As you watch it, keep in mind that demo is using a dummy.  In real life, the mother would (ideally) not be on her back.  The baby would be expelled by contractions and slipout (you absolutely do not need to tug at the baby or separate the mother's labia.).  If you see the cord is around the neck, this manoeuver helps to avoid pulling the cord.  The baby can then be passed onto the mother's body.  Keep in mind the length of the cord.  Sometimes, you may only be able to have the baby low (if the cord is short), sometimes the baby can reach the mother's chest.  If the cord is short, once the placenta is birthed, you can adjust the placement.